sexta-feira, 28 de agosto de 2009

cataract operation

I suppose that it is difficult to get any average response to an eye condition and all of us view the world differently, i have finally made it through the making of the windows and shutters for the house in france and managed to work with my vision very much impaired, it has been an odd experience but not all that worrying. When some years ago I heard of my Mother and eldest brother, having to have cataract operations I assumed the operation was to scrape the lens and there by remove the offending opaque part of the lens, leaving a clear but thinner lens. Long before that I guess I would have imagined that Monet was almost blind, lacking sight, because of his cataracts. The real answer is that the lens is not like that, the lens is a clear sack that envelopes a protein lens, the protein with time will become harder and lose its transparency, we are all living longer and that is the first real reason for the cataract to form, degradation of the protein with time. It has been described as the white of an egg that is gradually warmed and begins to turn from transparent to white as well as hardening.
I had suffered a degree of problems with my eye and this culminated last summer in a detached retina. The operation meant that my eye had to be cut open and the retina reattached, with great skill my surgeon did the operation and in so much the operation was a success. I have however, since that date had my eyesight gradually change and deteriorate, it has been slower than my surgeon thought, he told me within two months of the operation that I had the signs of a cataract developing and that was normal as the eye reacted to the surgery. I have gradually upped my specs from -3.0 to -8.5 and then realised that I needed to see the surgeon about an operation, I did this on my return to Edinburgh during may this year and we decided on a date three weeks before I was due back to Brazil. It was then that I decided to look up the operation on the internet, still un aware of what was to be done, everyone uses the phrases like scraping the lens, when in fact the lens is removed and an artificial one is put in its place.
The process is simple but not without great skill from the surgeon, the eye is first treated to several drops of dilating fluid, spaced out over several hours, then in the theatre I was given injections of local anaesthetic into both eyelids and three injections into the eye itself, not that comfortable and much like the soreness that you would get from the dentist injecting into the top gum of your mouth.
The process is to cut a small hole into the front of the sac that holds the lens, this is done by inserting a thin rod of a lazer and the surgeon burns a hole with it, for my part there was no discomfort , I watched as the lazer formed a circle of grey, then an ultra sound rod is inserted through the same tiny cut, about 2 mm round, this is used to mash the old lens into a fluid which is then withdrawn through a tube and is much like a vacuum cleaning around the inside of the clear sack, a faint wobbly image is the next sign that the surgeon had slipped in the new lens. This is a soft lens that is some how fold into a tiny tube and injected into the empty lens sack, once inside the lens unfolds to fill the cavity. It is then followed by the surgeon injecting an anti biotic into the same pocket and the operation is finished, I do not know the time taken but would think that the time in theatre was not much more than 20 minutes, I had arrieved at the hospital at 15.00, went to surgery just after 17.00 and was back in the waiting area having tea and sandwiches by 18.00, then collected at 18.30.
I am now on some drops into the eye for the next week and careful not to get any infection, my eye was not ready to see the world when i left the hospital, it was ready to acknowledge light but not much more, the next morning I found i could get some vision and I am at the moment finding a daily improvement in clarity and focus. Colours are my most immediate response to the operation, all are so much more vivid and good contrast, for I had found that before it I was looking with a blurred, misty and pale vision. I am very short sighted in my left eye and have glaucoma as well, so at the moment I am not able to wear my specs since the new lens is almost perfect vision setting and I had a -8.5 sight before in that eye, so I will have to wait for the right eye to become stable before I can go to the optician again and get a new prescription to suite both eyes as they are now. My surgeon is going to take a look at the left eye this comming monday, I feel that i would like to have a corrective lens put into that eye to leave me with balanced vision and no need to wear specs other than for reading, this may depend on whether my surgeon feels that there is good enough reasons to do the operation, I think there are but realise that any operation as its risks and possible side effects, i would be silly to risk a new detached retina or worsen the already bad glaucoma in the left eye, but the positive effect of having both eyes with good lens and no specs seems a great prospect...... see how I go....I had the operation on Tuesday evening and it is Friday afternoon now........

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